Payer and practice participation remained relatively stable during the first three years of CPC. However, although small, the number of practice withdrawals increased during the final months of PY2015, with most of these practices leaving to join Medicare accountable care organizations (ACOs).

CMS and other participating payers continued to provide significant support for CPC practices and, in general, practices found these supports helped them accomplish the required work.

Based on data from our practice survey, CPC practices’ approach to risk-stratified care management is more advanced than that of comparison practices. CPC practices' approaches to other aspects of care delivery are slightly more advanced than comparison practices.

Improvements in CPC practices’ care delivery between the start of CPC and the third program year (2015) had few statistically significant associations with reductions in hospitalizations, ED visits, expenditures, and other outcomes over the same time period.

In October 2012, the Center for Medicare & Medicaid Innovation of the Centers for Medicare & Medicaid Services (CMS), in a unique collaboration between public and private health care payers, launched the Comprehensive Primary Care (CPC) initiative to improve primary care delivery in seven regions across the United States. CPC requires that practices meet annual milestones that help them build the capability to deliver CPC’s five functions: (1) access and continuity, (2) planned chronic and preventive care, (3) risk-stratified care management, (4) patient and caregiver engagement, and (5) coordination of care across the medical neighborhood. To help participating practices achieve these functions, CPC offers three main supports: enhanced payment, data feedback, and learning activities and technical assistance. The substantial transformation involved in executing these functions is expected to achieve better health care, better health outcomes, and lower costs. This third annual report to CMS describes the implementation and impacts of CPC over its first three years.